Between 17 and 25 February 2016, the National IHR Focal Point
for the Kingdom of Saudi Arabia notified WHO of 7 additional cases of
Middle East respiratory syndrome coronavirus (MERS-CoV) infection.

Details of the cases

A 56-year-old male from Hail city developed symptoms on 20
February and, on 23 February, was admitted to hospital. The patient, who
has no comorbidities, tested positive for MERS-CoV on 24 February.
Currently, he is in critical condition in ICU. Investigation of history
of exposure to the known risk factors in the 14 days prior to the onset
of symptoms is ongoing.

A 60-year-old male from Najran city developed symptoms on 20
February and, on 22 February, was admitted to hospital. The patient, who
has comorbidities, tested positive for MERS-CoV on 24 February.
Currently, he is in stable condition in a negative pressure isolation
room on a ward. The patient owns sheep, goat and cows. Investigation of
history of exposure to the known risk factors in the 14 days prior to
the onset of symptoms is ongoing.

A 53-year-old, non-national male from Abha city developed
symptoms on 11 February and, on 20 February, was admitted to hospital.
The patient, who has comorbidities, tested positive for MERS-CoV on 22
February. Currently, he is in critical condition in ICU. Investigation
of history of exposure to the known risk factors in the 14 days prior to
the onset of symptoms is ongoing.

A 74-year-old male from Afif city developed symptoms on 15
February and, on 21 February, was admitted to hospital. The patient, who
has comorbidities, tested positive for MERS-CoV on 22 February.
Currently, he is in stable condition in a negative pressure isolation
room on a ward. The patient owns camels and has a history of frequent
contact with them and consumption of their raw milk. He has no history
of exposure to the other known risk factors in the 14 days prior to the
onset of symptoms. The Ministry of Agriculture was notified and their
investigation is ongoing.

A 28-year-old, non-national, female health care worker from
Alkarj city was identified through contact tracing of
laboratory-confirmed MERS-CoV cases (see DON published on 29 February –
case no. 1 and 2). The patient, who has no comorbidities, tested
positive for MERS-CoV on 18 February. Currently, she is asymptomatic in
home isolation. The patient has no history of exposure to the other
known risk factors in the 14 days prior to detection.

A 24-year-old, non-national male from Riyadh city developed
symptoms on 14 February and, on 16 February, was admitted to hospital.
The patient, who has no comorbidities, tested positive for MERS-CoV on
17 February. Currently, he is in critical condition in ICU.
Investigation of history of exposure to the known risk factors in the 14
days prior to the onset of symptoms is ongoing.

A 53-year-old male from Riyadh city developed symptoms on 13
February and, on 16 February, was admitted to hospital. The patient, who
has comorbidities, tested positive for MERS-CoV on 17 February.
Currently, the patient is in stable condition in home isolation.
Investigation of history of exposure to the known risk factors in the 14
days prior to the onset of symptoms is ongoing.

Contact tracing of household and healthcare contacts is ongoing for these cases. Globally, since September 2012, WHO has been notified of 1,651
laboratory-confirmed cases of infection with MERS-CoV, including at
least 590 related deaths.

The second update is on the case from Qatar (seeQatar MOH Statement On 1st MERS Case Of 2016) announced on Feb 22nd. As reported previously, this is a Qatari who had been residing in Saudi Arabia where he owned, and visited, a camel barn at the time he fell ill.

On 21 February 2016, the National IHR Focal Point of Qatar
notified WHO of 1 additional case of Middle East respiratory syndrome
coronavirus (MERS-CoV) infection.

Details of the case

A 66-year-old, male, Qatari national developed symptoms on 18
February while in Saudi Arabia, where he had stayed for approximately 2
months. On 19 February, the patient sought health care in a hospital in
El-Hassa Region, Saudi Arabia, where he was treated symptomatically and
discharged. The patient developed additional symptoms on 20 February. On
the same day, as his condition deteriorated, the patient was
transferred by ambulance to a hospital in Doha, Qatar. The patient, who
was a heavy smoker and had comorbidities, tested positive for MERS-CoV
on 21 February. He passed away on 7 March.

The patient owned a camel barn in Saudi Arabia and frequently
visited it. He had a history of frequent contact with the camels and of
consumption of their raw milk. He had no history of contact with the
other known risk factors in the 14 days prior to the onset of symptoms.

The Ministry of Public Health of Qatar carried out case
investigation and contact tracing. Respiratory swabs were collected from
the patient’s household and healthcare contacts in Qatar resulted
negative for MERS-CoV. Household contacts were monitored until the end
of the 14-day exposure period to the case.